Time-to-Positivity of Blood Cultures in Children With Sepsis

被引：33

作者：

Dierig, Alexa ^{[1
]}

Berger, Christoph ^{[2
,3
]}

Agyeman, Philipp K. A. ^{[4
]}

Bernhard-Stirnemann, Sara ^{[5
]}

Giannoni, Eric ^{[6
,7
]}

Stocker, Martin ^{[8
]}

Posfay-Barbe, Klara M. ^{[9
]}

Niederer-Loher, Anita ^{[10
]}

Kahlert, Christian R. ^{[10
]}

Donas, Alex ^{[8
]}

Hasters, Paul ^{[11
]}

Relly, Christa ^{[2
,3
]}

Riedel, Thomas ^{[12
]}

Aebi, Christoph ^{[4
]}

Schlapbach, Luregn J. ^{[4
,13
,14
,15
]}

Heininger, Ulrich ^{[1
]}

机构：

[1] Univ Basel, Childrens Hosp, Infect Dis & Vaccinol, Basel, Switzerland

[2] Univ Childrens Hosp Zurich, Childrens Res Ctr, Div Infect Dis, Zurich, Switzerland

[3] Univ Childrens Hosp Zurich, Childrens Res Ctr, Hosp Epidemiol, Zurich, Switzerland

[4] Univ Bern, Bern Univ Hosp, Inselspital, Dept Pediat, Bern, Switzerland

[5] Cantonal Hosp Aarau, Childrens Hosp, Aarau, Switzerland

[6] Lausanne Univ Hosp, Serv Neonatol, Dept Mother Woman Child, Lausanne, Switzerland

[7] Lausanne Univ Hosp, Infect Dis Serv, Lausanne, Switzerland

[8] Childrens Hosp Lucerne, Dept Pediat, Luzern, Switzerland

[9] Univ Hosp Geneva, Childrens Hosp Geneva, Pediat Infect Dis Unit, Geneva, Switzerland

[10] Childrens Hosp Eastern Switzerland St Gallen, St Gallen, Switzerland

[11] Univ Hosp Zurich, Dept Neonatol, Zurich, Switzerland

[12] Cantonal Hosp Graubuenden, Dept Pediat, Chur, Switzerland

[13] Univ Queensland, Fac Med, Brisbane, Qld, Australia

[14] Univ Queensland, Mater Res Inst, Paediat Crit Care Res Grp, Brisbane, Qld, Australia

[15] Childrens Hlth Queensland, Lady Cilento Childrens Hosp, Paediat Intens Care Unit, Brisbane, Qld, Australia

来源：

FRONTIERS IN PEDIATRICS | 2018年 / 6卷

基金：

瑞士国家科学基金会;

关键词：

sepsis; children; bacteremia; blood cultures; time-to-positivity; EARLY-ONSET SEPSIS; STREAM INFECTIONS; ANTIBIOTIC EXPOSURE; CONTROLLED-TRIAL; INFANTS; VOLUME; PROCALCITONIN; POPULATION; MANAGEMENT; DIAGNOSIS;

D O I：

10.3389/fped.2018.00222

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Background: Blood cultures are essential for the diagnosis and further appropriate treatment in children with suspected sepsis. In most hospitals, children will be empirically treated or closely monitored for at least 48 h awaiting results of blood cultures. Several studies have challenged the optimal duration of empiric treatment in the era of continuously monitored blood culture systems. The aim of our study was to investigate time-to-positivity (TTP) of blood cultures in children with proven sepsis. Methods: The Swiss Pediatric Sepsis Study prospectively enrolled children 0-16 years of age with blood culture positive sepsis between September 2011 and October 2015. TTP was prospectively assessed in six participating academic pediatric hospitals by fully automated blood culture systems. Results: In 521 (93%) of 562 bacteremia episodes (493 children, median age 103 days, range 0 days-16.9 years) a valid TTP was available. Median TTP was 12 h (IQR 8-17 h, range 0-109h). By 24, 36, and 48h, 460 (88%), 498 (96%), and 510 (98%) blood cultures, respectively, were positive. TTP was independent of age, sex, presence of comorbidities, site of infection and seventy of infection. Median TTP in all age groups combined was shortest for group B streptococcus (8.7 h) and longest for coagulase-negative staphylococci (16.2 h). Conclusion: Growth of bacteria in blood cultures is detectable within 24 h in 9 of 10 children with blood culture-proven sepsis. Therefore, a strict rule to observe or treat all children with suspected sepsis for at least 48 h is not justified.

引用

页数：9